APPLICATION 
Name: _________________________________________________________________________ 
Address: _________________________________________________________________________ 
City/State/Zip: _____________________________________________________________________ 
Phone: _______________________ Email: _____________________________________________ 
Enclosed is $________ for ______ Golfers @ $175 each 
Enclosed is $________ for _______Additional Dinners @ $25 each 
Enclosed is $________ for _______Grand Raflle Tickets @ $25 each 
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I can't play but I would like to sponsor a golfer. 
Enclosed is $______ for Sponsored Golfers @ $175 each OR 
Additional Donation: $___________ 
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TOTAL AMOUNT $ ______________ 
____ Check # __________ (Name/Company on check) ____________________________ 
____ VISA _____ MC# ______________________________Expiration Date: __________ 
Please bill my credit card for $ _____________________( total amount) 
Signature: ____________________________________ 
My check/credit card covers play for the following participants: 
Name Address Phone SCGA# Low Index 
1.___________________________________________________________________________ 
2.___________________________________________________________________________ 
3.___________________________________________________________________________ 
4.___________________________________________________________________________ 
Name(s) of persons coming just for dinner: __________________________________________ 
MAIL TO: 
CORONADO ROTARY CLUB ATTN: GOLF 2006 
P.O. BOX 180734 
CORONADO, CA 92178 
FAX 
(CREDIT CARDS ONLY) 
(619) 437-4284 
DON'T FORGET TO ENCLOSE YOUR CHECK!